Finding the Healing Part in Psychotherapy

One of the things I have been interested in since I joined this field is working with people who are struggling with medical complications. A medical complication can be sudden, diagnosed in a routine checkup with your physician. Some of the common diagnoses in such routine checkups are diabetes, thyroid issues, hypertension, respiratory disease, heart disease, and high cholesterol. Don’t feel frightened if you didn’t see your medical condition listed. There is a place for all in therapy! One question I get a lot when I tell someone I specialize working with individuals with medical complications is, “How do you cure a medical issue with psychotherapy?” I do not advertise psychotherapy being a cure for medical issues. I do, however, look at how we can verbalize the anxiety and stress that comes with these complications. For example, did you know it is common for people with diabetes to suffer from nightmares if untreated? This is one area psychotherapy can help. I help the individual look at the underlying emotional state of bearing health issues.

Medical complications can take a toll in many areas of your life. One important area is your mental health. If your mental health has declined, then other areas take a toll as well: job performance, family conflicts, sleep patterns, alcohol consumption, and much more. In therapy, together with the client, we look closely at what areas of your life are being harmed. We look at creative ways you can manage whatever is happening biologically. Internally we carry these different kinds of emotions that happen so fast we don’t realize their influence on the body. If we can look at these internal drives then perhaps we can manage symptoms of hypertension, weight issues, high blood sugar, or even diet and medication management. For instance, it is hard to regulate sugar intake when a person is in a repeated pattern of alcohol use or sleep issues. We crave more sugar under these circumstances.

It is common to feel vulnerable when addressing these issues in therapy. It is uncomfortable for most because verbalizing this in therapy comes with a kind of fear of not being in control. No one wants to feel they are not in control. You will find support in therapy in managing stress, anxiety, and other emotional issues related to health conditions. If this resonates with you, do not feel shame for asking for help.

Give Life Meaning

We’re heading into the last few months of 2020 and this year feels a whole lot different! For many years we may have relied on the upcoming months to be the season of joy and full of festivities around the holidays. Instead as this holiday season approaches, I have felt the heaviness, difficulty, and uncertainty of how the next few months will unfold. I for one can say that this is completely understandable! After all we have had to experience the many changes and stress influenced by the COVID-19 pandemic. In addition, the news constantly reminds us of the additional challenges that are taking place socially, politically, and economically.

If you are struggling to stay hopeful and positive right now, then this article is dedicated to you. I’m also struggling to stay hopeful and positive right now. It’s discouraging and frustrating to dig deep to find positivity when the next challenge or problem seems to be right around the corner. Recently, I walked into my office feeling a lack of confidence and worry on how I would share hope and positivity with my clients when everything outside of my office seemed so negative. Additionally, to be more vulnerable with you guys, that moment terrified me! For the last 5 years, Reconnecting Relationships Therapy has been my home away from home. It has been an honor to serve the Dallas Fort Worth area by working with my clients. All these years my heart has been filled with gratitude and excitement as clients have shared their stories and invited me to help them create positive changes. Although most stories that are shared with me in therapy are filled with suffering and conflict, I’ve known what my purpose has been all these years. Feeling those negative emotions as I walked into my office, forced me to pause and acknowledge my current predicament.  I’m struggling with sadness, fear, frustration, and hopelessness. Since I hadn’t been diligent in processing these negative emotions outside of work, they were now making me question my purpose.

According to the CDC, about 41% of the U.S. population reported experienced mental health issues as a result of the pandemic. Common mental health issues reported included anxiety, depression, trauma-related symptoms, and substance use disorders. If you are not experiencing one of these mental health issues, perhaps you have noticed other symptoms associated with the increase of stress and anxiety.

 So, what can we do? We may not be able to control many things about a pandemic. We definitely can’t bury our heads in the sand and pretend that life is not filled with various challenges right now. What we can do to gain some stability, is to find what is in our control. We can control how we use our time sheltering at home. We can control what decisions we make that care for our physical and mental health. We can decide to have a mindset and practice actions that remind us that our life still has meaning. We can choose to live a life that is meaningful and has purpose. The most valuable support we can have at this time is finding that our life still has meaning when we are attempting to cope, survive, and restructure during difficult times.

One of my favorite books is by Viktor Frankl, which I find always reminds me of man’s strength and resilience in the worst situations. In his book, Man’s Search for Meaning, he describes his experience while being held at a concentration camp during World War II. He reminds us of what helps people survive desperate circumstances, “The meaning of life is to give life meaning.” In times of uncertainty, crisis, or change we have the power to choose what will give us meaning or purpose. I may not like the changes and negative emotions that the pandemic has brought but I can choose to focus on what gives my life meaning. I’m committed to continue helping couples reduce conflict and to help my clients experience joy in their relationships! 

The Dynamic Dr. Dixon

Brian Dixon, M.D.

As a therapist, I often find that clients are hesitant or skeptical about taking medications for mental health purposes.  Some individuals explain that medication in the past has not worked effectively while others share their distrust in psychiatrists or “pill pushers.”  So, I sat with Brian Dixon, M.D. recently to see if he could shed some light on his approach and process to psychiatry. 

What led you to practice psychiatry?  And how did you know it was right for you? 

I knew psychiatry was the ideal specialty after I completed a family medicine rotation in medical school and realized how mental health was a key component in treatment compliance. And when I learned that psychiatrists have more time to truly dig deeply, I knew it was the field for me.

What is your style or approach to working with your patients?

I fully believe in meeting patients where they are and helping them towards their best self; this only occurs when patients are ready for change so I establish people’s motivation for change early in the process.

What have you found to be the most difficult to treat?

My “waterloo” in psychiatry is likely eating disorders. I employ lots of behavioral techniques and though most eating disorders have a large behavioral component, the psychodynamics stretch me pretty thin and puts me at risk for compassion fatigue.

What is the biggest misconception about psychiatry that you have come across? 

That it’s fast and easy. Like a surgeon doing a Whipple procedure [a 10-hour delicate pancreas surgery] psychiatrists open up a person’s psyche and help them build insight into themselves. It’s a process that’s scary and complex and can’t be done in a session or two. Reminding the public that as physicians, psychiatrists are trained in all aspects of mental healthcare and building a comprehensive treatment plan takes training and patience and helping someone feel better is a process.

When you notice a patient is worried or anxious about the idea of taking medication, how do you move forward?

First and foremost, the first option is always no medication. As one of my training psychiatrists taught me – no one is born with a Ritalin deficiency – meaning that we use medications currently to bridge people to a time when they are feeling better. If people are interested in medications, I then walk them through all options explaining common risks, benefits, and side effects so that they get to choose the option that works best for them and their situation.

I understand you also see adolescents and children.  How young is too young? 

There’s a field of infant psychiatry so I’d say no one’s too young! My youngest is 3 and since there are very few medications approved for that age, I blend mainly behavior modification into my treatment plans.

And how do you adjust from working with an adult to working with a minor?

Training. The best part of being a psychiatrist is that you go through an intense residency program for 4-5 years.  During that time, you learn to juggle complex treatment choices that come at you from all angles. Thus, it’s not tough to adjust when it’s literally built into our training.

What do you recommend to those who are searching for a psychiatrist?  What questions should people ask?  What should they be looking for?  Or steering away from?

The most important and first question is “Are you ready for change?” It’s okay if someone isn’t ready for change but [instead] reaching towards possible medication (which many psychiatrists tend to use as part of a treatment plan.) If you’re ready to ask, the next question is specialty and focus. I remind patients that orthopedic surgeons are surgeons and could remove your gallbladder but you’d likely want a general surgeon to do it. The same goes for psychiatry. There are generalists and subspecialists, and both genres have focuses so be sure to ask if they’re a good fit. Online reviews are notoriously inaccurate so I encourage everyone to steer clear of what reviews they read in regards to the quality of mental health services in Fort Worth; I know many of the providers and they’re quite good.

In your line of work, it can be very demanding and challenging.  So, how do you find balance between tending to patients and taking care of your own self-care needs?

The hardest balance, strangely, isn’t practicing psychiatry (this is where my amazing training kicks in.) Honestly, running a small business is the tougher of the two endeavors, and self-care tends to take a back seat when there’s work to be done until the wee hours. I’m blessed to sing in a great chorus in Dallas and have fantastic friends in Fort Worth to keep me sane.

Lastly, I want to say congratulations on your recent recognitions for 40 under 40 by the Fort Worth Business Press AND Top Doc in Psychiatry by Fort Worth Magazine.  How awesome!  So, what’s next for you?  Can you tell us what you plan to accomplish next?

Thanks!  It’s quite an honor to be acknowledged for building a successful private practice both business wise and clinically.  My goal for 2017 is to tackle healthcare reform.  Our current system is broken as it’s based on commercial insurance.  I have a novel solution that returns healthcare to the local level and power to the citizens and I’m sharing it far and wide through all public and social media outlets.  My goal is to get my idea into the common discourse so that we can change healthcare starting today.

Something that comes across loud and clear when hanging out with Dr. Dixon is his friendly, down-to-earth disposition.  After the interview, Dr. Dixon shared with me his desire to make improvements in how mental health is not only treated but also perceived.  He is a man interested in helping others, however he understands and respects his limits.  He often integrates the expertise of other professionals to enhance his mental health plan for his patients. 

Your mental health is essential in your day-to-day living and making the decision to seek a psychiatrist is not always easy.  Some people have preconceived notions about meds and doctors that make it difficult to embrace a consultation with a psychiatrist.  I hope today's Q&A helps you gain a better understanding of what to expect when seeking help from a psychiatrist.  Thank you, Dr. Dixon, for sharing with us what you do and how you do it!  

Brian J. Dixon, M.D. is a Board-Certified Adult, Child & Adolescent Psychiatrist with an active private practice in Fort Worth, TX.  He believes in treating the whole patient using a unique blend of behavior modification and therapy while minimizing medications.  His practice’s goal is to reintegrate mental health into our modern lifestyles.  www.progressivepsychiatry.org

Why Healthy Habits Fail (And How Yours Can Succeed) by Paige Johnson

By now, many people have either forgotten about their New Year’s resolutions or just given up on them. Pledging to be more healthy this year is a great idea, especially if it’s what you really want. Then why is it so hard to get on a healthy kick? More importantly, what can you do to get healthy habits that can last a lifetime?

Image Source:  Pixabay

Why Habits Fail

The problem is that many people expect to make a huge change in their lives without much effort. If you’ve ever heard someone say, “Yeah, I’ll just hit the gym a few times a week this year,” then you know what that sounds like. Here are a few reasons why such a change is hard to do.

Too much focus on a goal: Sometimes, being healthy is so enticing that you forget to plan how to get there. If you’re thinking about losing 25 pounds to look awesome in that wedding dress, that’s a great motivator — but it’s not a plan. It’s a goal. You still need to change your unhealthy habits or you’ll never get there.

Going too far at the start: Often, people go too far and try to change everything at once. You might think that you need to make an extreme change, and that could be true. But any plan that includes dropping all snacks and desserts when you’ve been enjoying both every day for years is doomed to fail. Your mind isn’t ready for such a drastic change.

Tricks To Getting Healthy Habits

Don’t worry, just because it’s hard doesn’t mean it’s impossible. You just need to focus on three tricks to help get those healthy habits to stick around.

Start with small, concrete changes to your daily routine: Don’t worry about the goal yet. That will happen if you follow the right steps to get there. Instead, create a list of concrete, actionable tasks. Don’t bother with vague plans like, “I’ll eat fewer calories,” because what does that mean in your day-to-day life? What changes are you able to make that leads to fewer calories?

If you can mentally mark off a checkbox with it, then it’s more likely to become a habit over time. “I will stop ordering that 600-calorie frappuccino and get a plain, unsweetened cup of coffee instead” is something you can clearly see and do. (Or not do, as the case might be.)

Focus on your most unhealthy habit: Have you ever tried carrying in every bag from a huge grocery store trip? Even if you manage to not drop stuff, it's probably not good for your back or hands. That’s why you need to stop trying to change all your unhealthy habits — it’s just too much to do at once. Instead, pick your worst habit and change it.

If your goal is to be happier, don’t try cutting out everything that makes you sad. Find the one thing that really gets in the way of happiness and change that. Wait until the change sticks, then move on to something else.

Spend more time with people who already have healthy habits: Doing something occasionally is not a habit. You need to do it repeatedly over time or it’s not a habit. But that gets hard to do when the people around you are doing the exact opposite.

If drinking too much beer is the unhealthy habit you want to change, hitting the bar with your drinking buddies is a bad idea. You don’t need to stop being friends with people, but at least until the habit is established, spend more time with those who already have those healthy habits. Let peer pressure actually work for you.

Remember that you already have unhealthy habits. You’re not starting with a blank slate. That’s why getting healthy habits is tough. By staying focused on actionable changes, targeting your worst habit first, and surrounding yourself with supportive people, you can make those New Year resolutions turn into lifelong, healthy habits.

Paige Johnson calls herself a fitness nerd. She prides in doing strength training, cycling, and yoga. She is a personal trainer and regular contributor to LearnFit.org.

From Sibling Rivalry to Sibling Revelry: It CAN Happen!

“Mom!  Jimmy hit me!”  

“Well what were you doing to him?”  

“Nothing!  He started it!”

Do you find this being typical dialogue in your home?  At some point in parenting, if you have more than one child, sibling rivalry will rear its ugly head.  We can’t escape it entirely, but there are ways to lessen this problematic situation.  

Let’s begin by defining it.  According to Merriam-Webster, it is a “competition between siblings especially for the attention, affection, and approval of their parents.”  Oh man!  That sure does put parents in an awkward position.  

Who argues?

Although all kids have a tendency to argue, the closer-in-age and same-gender children tend to have more drama than any other set of siblings.  Being similar puts kids at a higher advantage for promoting competition.  The closeness in age can put pressure on the younger one to keep up with the older one, and if they are of the same gender, both kids can find themselves competing for the attention of a specific parent.  

Normal or Not?

You often hear parents explain, “Oh, they fight like any other normal set of siblings.”  But what is normal?  Compare one person’s perspective to the next and it may be completely different.  A better way to examine it might be to consider how often sibling rivalry occurs in the home and how intensely it is experienced.  How does their rivalry affect the family dynamics and each member individually?  

In 2012, a research study indicated that conflictual sibling rivalry is closely related to negative behaviors such as aggression and anti-social tendencies (including substance use), whereas healthy sibling relationships are linked to positive interactions with friends and intimate partners, a greater ability to adjust to academic pressures, and improved prosperity and mental health. In a separate study (2013), sibling aggression is closely linked to the decline of positive mental health.  Additionally, whether aggression comes from a sibling or a peer, the effects on well-being are the same.   

On a positive note, recent research shows that parents can also benefit from practicing conflict resolution with the kids in the home.  During the study, as parents taught and guided their children to communicate positively with siblings, mom and dad were able to borrow the same tactics.  Parents became better at managing their own emotions, therefore improving their overall mental health.  

So what can you do?

Avoid comparisons and labels.  Comparing one child to the next only promotes competition. Instead, acknowledge their own interests and express your support for their individuality.  Oftentimes, children are given labels in the family such as “the smart one” or “the artsy one.”  It may seem harmless, but placing labels can actually restrict the child from attempting something they find to be challenging.  

Don’t get caught in the middle.  Don’t act as a judge or try to determine who is right and who is wrong.  This only creates more conflict and hostility between siblings.  First, allow siblings to resolve their own arguments, although if you see the argument escalating or getting out of hand, then it is time to step in.  Never allow kids to become physically abusive with one another.  Nonetheless, use this opportunity to guide them to making good decisions about communication.  Listen to what they are trying to say to each other and steer clear from making criticisms.  Many times, kids have difficulty expressing themselves which only frustrates them even more.  You might try something like, “It sounds like what your brother is trying to say is…” or “What do you hear your sister say?” Ask each child to clarify if the message is coming across inaccurately.        

Spend “quality” time with each child.  Spend time with each child and as a family.  This does not mean you have to spend a lot of money or a great deal of time.  Life can get pretty busy but a 10 minute “quality” conversation can go a long way with kids.  Put the phone away and make sure your child gets your full attention.  Ask questions and show interest.  The more your kid feels connected to you, the less they feel the need to act out or compete with their sibling.  

Aside from taking certain steps to minimize sibling rivalry, it’s necessary to understand the longstanding emotional and mental effects that can occur if ignored.  Although sibling rivalry might be all too common in our society, it does not excuse us from being proactive.  As parents we want to see our children thrive and grow, and part of becoming that healthy individual means learning to resolve conflict with others.  The early relationship building experiences a child receives can leave a lasting impact on their mental health for years to come, but also your own!  

References

Feinberg, M.E., Solmeyer, A.R., Hostetler, M.L., Sakuma, K., Jones, D., & McHale, S.M. (2012). Siblings are special: Initial test of a new approach for preventing youth behavior problems. Journal of Adolescent Health, 53(2), 166-173.  doi: 10.1016/j.jadohealth.2012.10.004

Ravindran, N., Engle, J.M., McElwain, N.L., & Kramer, L. Fostering parents’ emotion regulation through a sibling-focused experimental intervention. (2015). Journal of Family Psychology, 29(3), 458-468.  doi: 10.1037/fam0000084

Tucker, C.J., Finkelhor, D., Turner, H., & Shattuck, A. (2013). Association of sibling aggression with child and adolescent mental health. Pediatrics, 132(1), 79-84. doi: 10.1542/peds.2012-3801

http://www.sylviarimm.com/article_sibcomp.html